This study aims to develop an improved neonatal hearing screening device that will incorporate novel testing procedures combining simultaneous air and bone conduction testing so that mild hearing losses (<35 dB nHL) are better and consistently detected. The proposed device will address the current need for a more sensitive hearing screening tool by stimulating at lower levels and providing bone conduction stimulation in order to differentiate between sensorineural and conductive components. Intelligent Hearing Systems has previously developed a Stimulus Intensity-Ramping Technique for quickly determining frequency specific AEP hearing thresholds. This technique will be expanded and combined with bone conduction testing using various approaches, including: A) Interweaving Air-Bone stimulation, B) Dual-Rate Air-Bone stimulation and C) Overlapping Air-Bone Intensity-Ramping Stimulation. A new generation of high fidelity bone-conduction stereo headphones will be used to deliver stimuli. During Phase I, the current software and hardware of the IHS hearing screening device will be modified to accommodate the proposed dual-ear simultaneous air and bone conduction testing paradigm. Experiments will be conducted to determine the feasibility of combining these testing paradigms and to determine their effectiveness and efficiency. Data will be collected from 10 young adults with normal hearing and 15 newborns. Newborns will be tested in order to determine the feasibility of the proposed technique on the target population. During Phase II, a comprehensive clinical study will be conducted on newborns. This new approach will allow for better management of hearing loss cases and implementation of more efficient rescreening policies. PUBLIC HEALTH RELEVANCE: Newborn hearing screening is an important assessment tool in the early identification of infants hearing loss. The implementation of the proposed automated dual air and bone stimulation and analysis techniques is expected to greatly improve thereliability and validity of hearing screening. As such, the proposed work will greatly impact public health by developing better newborn hearing screening systems.